"The fatigue will always be there but will be minor at times. When the fatigue becomes bad you need to rest as much as possible. I take vitamin B-12 injections twice a week for fatigue. It helps quite a lot."- quote from a hepatitis C patient.

FATIGUE IN MULTIPLE SCLEROSIS by David Perlmutter, M.D.

Townsend letter for doctors and patients/november 1995

In addition, it is critically important to recognize the importance of vitamin B-12 metabolism in the pathogenesis of multiple sclerosis as we described in a previous edition of TLfD (April 1993, pp. 304-305). Although we typically continue to assess vitamin B-12 levels, we have been more impressed of late with the usefulness of urine methylmalonic acid in providing more relevant information as to B-12 status.

We generally supplement our multiple sclerosis patients with high dosage vitamin B-12 given by IM injection. Typically, we will begin treatment with 1,000 mcg. of vitamin B-12 administered IM on a daily basis for a two-week period of time followed by a weekly injection for the following four to six weeks and then continue with 1,000 mcg. IM on a monthly basis.

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